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Chinese Journal of Clinical Pharmacology and Therapeutics ›› 2026, Vol. 31 ›› Issue (3): 313-323.doi: 10.12092/j.issn.1009-2501.2026.03.003

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Unraveling the molecular mechanisms of modified Er-Miao-San (MEMS) in acute gouty arthritis: a multidisciplinary integration of network pharmacology, molecular docking, and experimental validation

Xiaomian LIU1(), Ying LIU1, Wenjing TU1, Shuo ZHANG1, Gaoyan ZHU1, Yuyan CUI1, Xiaoyu CUI1, Yixuan YANG1, Xiaobing LI2,*(), Hongtao GUO3, Dong LI4, Xiaojuan HE5   

  1. 1. School of Medicine, Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China
    2. School of Traditional Chinese Medicine, Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China
    3. Department of Rheumatology, The First Affiliated Hospital of Henan University of Chinese Medicine, Zhengzhou 450000, Henan, China
    4. School of Clinical Medicine, Henan University of Chinese Medicine, Zhengzhou 450046, Henan, China
    5. Institute of Clinical Basic Medicine, China Academy of Chinese Medical Sciences, Beijing 100700, China
  • Received:2025-05-09 Revised:2025-08-28 Online:2026-03-26 Published:2026-04-03
  • Contact: Xiaobing LI E-mail:lxmianjyjy@163.com;baishaoyao@163.com

Abstract:

AIM: To investigate the therapeutic efficacy and potential mechanisms of modified Er Miao-San (MEMS) in the treatment of Acute Gouty Arthritis (AGA). METHODS: Network pharmacology, molecular docking, and molecular dynamics simulations were used to validate the interactions between the active components of MEMS and the targets associated with AGA. An AGA model was established in rats by injecting 25 mg/kg of monosodium urate (MSU) suspension into the right ankle joint. Treatment efficacy was evaluated by measuring ankle joint swelling, gait scores, and inflammation indices. Enzyme-linked immunosorbent assay (ELISA) was used to determine the serum levels of TNF-α, IL-6, IL-1β, IL-17, MDA, SOD, and GSH in AGA rats. Hematoxylin and eosin (HE) staining was performed to observe the pathological changes in the ankle joint synovial tissue, and Western blotting (WB) was used to analyze the protein levels of NLRP3 and STAT3 in the synovial tissue. RESULTS: Network pharmacology analysis identified quercetin, β-sitosterol, stigmasterol, and wogonin as the core active components in MEMS for the treatment of AGA. The key therapeutic targets of MEMS in treating AGA include TNF, STAT3, IL-6, and IL-1β. The core active components exhibited strong binding affinity and stable conformations with these targets. The key targets were predominantly enriched in signaling pathways, including NOD-like receptors, IL-17, and TNF. In vivo experiments demonstrated that MEMS effectively reduced ankle joint swelling, improved gait scores, alleviated synovial cell proliferation, neutrophil infiltration, and capillary congestion in AGA rats. It also lowered the serum levels of TNF-α, IL-1β, IL-6, IL-17, and MDA, while increasing the levels of SOD and GSH. Furthermore, MEMS downregulated the expression of NLRP3 and STAT3 proteins in the synovial tissue. CONCLUSION: MEMS alleviates inflammation and oxidative stress in AGA rats, exerting anti-inflammatory and antioxidative effects. Its mechanism of action may be associated with the modulation of inflammation factor levels via the inhibition of the STAT3/NLRP3 signaling pathway.

Key words: acute gouty arthritis, modified Er Miao-San, network pharmacology, molecular docking, molecular dynamics

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